complex hetergeneneous lesion on left ovray

[sas/sam]

I just received dx from nurse, not my dr of a complex heterogeneous lesion, most likely a hemmoragic cyst (don't know the size).  The radiologist recommends another ultrasound in 6-8 weeks.  That seems like a long time to me and I am having other symptoms of ovarian cancer for past week.  Feeling of being full, indigestion, abdominal gas and fullness.  I am scared to death that is is cancer and don't want to "wait and see".  Has any one out there had this diagnosis and what was your time frame for resolving this problem.  No history of ovarian cancer in my family.  Do have history of CLL and Hodgkins. (my only sister)  I would greatly appreciate any help/advise any one is willing to offer.

[irishpaw23]

I hope you all are still on the forum I am experiencing the same things!  talk to me or send a message and I can explain?

[wendycec]

Hi everyone! i am wondering how you are doing sam. i am in the same boat as you. i have something on my left ovary 7 cm and i have to have surgery i guess now. i am sooooo oworreid about it. like freakin out worried. the thought of the surgery is nothing to me....it is the thought of it being a cancer that truely has me in a panik state. i am so with you on worry. the doc is saying he belives it is probably a entometroma but also makes a point to tell me one can never know truly what is it untill it comes out. no matter what.....no ultra sound can tell any clinical person truly the diag. the doctors office iam dealing with is lets just say less then friendly. i got a call today saying dec 1st surgery and that was about it. another thing that is feaking me out is NO PAIN....just a twinging kind of thing that goes down my leg.wow i am such a wreck.

[sas/sam]

I am wondering if anyone out there has had night sweats with the diagnosis of a cyst or intermitten loose bowels?? I am getting a bit paranoid.  I have a repeat ultrasound for my cyst on Oct. 19.   Found out radiologist suggests "likely a hemmoragic cyst".  Still doesn't calm my nervous when I have all these other symptoms.  Nrevous, maybe that is part of it!!

Would appreciate any feedback.

[MickeyVicki]

Heterogeneous is just a medical term based on a Greek word meaning composed of dissimilar parts, or something like that!  KathyW is a nurse, perhaps she can give a better explanation. Lesion is a term referring to any local but abnormal structure or injury in the body. Basically, a cyst by definition is fluid-filled; by noting its heterogeneous nature the radiologist indicates he or she sees solids in the fluid.  If you have not seen your report, then consider that it might contain other information about the mass on your ovary, and your doctor could be using this information to make his or her decision about your condition. My report from the ultrasound was a full 'typed' page.  My doctor read the entire report to me, and discussed any terms that I did not understand.  However, the person preparing the report noted  at the end that my findings were "consistent with endometrioma, dermoid, or possible malignant..." - and at that point I stopped listening to the report; I did not want to see a copy.

[sas/sam]

I have been researching and am confused as to wording to describe cysts.  My radiology report said " complex hetergeneous lesion," it did not say anything specifically about solid particles.  My dr said this means that the cyst was not completely liquid and had some other components, (ie. blood, endometioma) that could be solid but not noted that way on u/s report.  I am assuming if the radiologist seen "solild particles" he would have noted that.  I know for sure there were no septations, because I asked after reading so many of your stories.  I understand septation in a cyst can be a little more suspicious than a complex cyst.  Does any one out there know about u/s terminology regarding reports??

Look forward to hearing from you.

[MickeyVicki]

Statistically speaking, ovarian cysts have only a 1 to 2 percent chance of being malignant.  There are some other factors, such as older age, being menopausal, or using certain fertility medications, that raise that risk to 3 to 5 percent.  So, statistically speaking, the greater chance is that the cyst will be benign.

I never developed pain in my leg, but towards the end I did have pain in my lower back and in my hip.  The feeling of gases rolling around in my abdomen was truly annoying and, yes, it would keep me awake at times.

I had my most noticeable symptoms beginning in late summer/early autumn last year, and I went to my doctor in November.  (I had my annual exam in the spring, and everything seemed to be fine at that time.) She sent me the following week for the ultrasound, and when the cyst was discovered, she did the CA-125 bloodwork, as well as other factors.  I only had that one ultrasound.  All the blood test results were normal.  We scheduled the surgery in December as I wanted my doctor to perform the surgery, and she was booked until then.  A total of about four weeks passed from the time of my first appointment and the surgery.   Surgery was necessary as a large endometrioma or a dermoid will not resolve on its own.  If the cyst ruptured, the contents would spill into the abdomen and cause pain and possibly infection.  I chose to have the cyst, ovary, and fallopian tube removed during the surgery.

[I should clarify that my doctor believed that my cyst would be either an endometrioma or a dermoid, and that it would be benign;  had she felt otherwise, then the surgery would have been performed immediately, instead of waiting another week.  Nurses at the hospital told me that my doctor had performed surgery within two days when a patient had a dangerous mass appear in imaging.]

I felt better within a few days of the surgery.  I was far from being completely recovered but I felt better.  My doctor stated that the body treats such a cyst as an injury or infection, produces prolactins in response, and this effect causes the general feeling of malaise.  I feel better now, some nine months after the surgery, than I have felt in years, and I suspect that my left ovary probably had some hormonal problem for quite some time.  I suppose my feeling better  might also just be due to the reduced estrogen I have now with only one ovary.  Whatever, I feel better.

[ptbmkg]

I have had two surgeries for dermoid cysts on both ovaries. The cysts returned about 7 years ago but were always quite small. I have had yearly ultrasounds and followups with the gynocologist and have always been advised that they are fine. Over the last 4 years I have also developed several fibroids. It has always been left up to me to make the elective decision for surgery.

I just went for my second check up in the past 15 months and the ultrasound revealed a 'strange mass'.   I have been experiencing pain on my left side for the last couple of months about a week before my period. He sent me for a CA125 test yesterday, and now I am completely freaked out. I guess it was the way he presented the findings of the mass and concerns of ovarian cancer. I have always had problems with bloating and indigestion but since my appoinment and the look of concern on my doctors face now I have myself convinced its serious. He did examine me after his intial discussion with me and apoligized for hie tone, and then said he felt it was probably a fibroid. Not sure what to think now.

I can relate to your feeling of fear right now and wanting to just get answers. I am also worried about the results of the CA125 being high as I think I am ovulating and I am told that can send back elevated levels. Anyone know how long it takes to get the results of CA125?

[sas/sam]

Thank you so much for the response. It is now 2 a.m. can't sleep due to the "rumbling of gas" in my inestines.  I know part of this could be nerves, but I am glad to hear someone else has had these symptoms.  Do you know what the likelyhood of these type of cyst to be cancer?  I can't find any real statistic on this.  How long after your original diagnosis did you have surgery and why?  Do these cysts sometimes go away on their own or do they have to be removed surgically?  With my history of endometriosis on left ovary which was adhered to my bladder and cul-de-sac, a c-section in 2002, increasing symtoms of return of endometriosis, I have a feeling this could also be an endometrioma.  That's certainly what I am hoping for.  How are you feeling now since you had your cyst removed?  Great I hope!!  I am feeling extreme pelvic pain on my left side, lower back pain and pain down my left thigh.  At this point I wish the dr would just take the thing out without any further test.  She won't do that without another ultrasound no sooner than 3 weeks.  Did you have repeat ultrasounds before surgery?  If so, how many?  

I so appreciate your comments.  They have really helped to alleviate some fear and be hopeful.  Any other comments or suggeestions would be greatly appreciated!!

[sas/sam]

I have decided not to have the CA 125 and CEA my dr said she would write an order for.  I know myself and will worry no matter what the results-high could or could not be cancer and low does not rule out cancer either.  I will have a repeat us on Oct. 13 to see what my cyst is doing.  At that point I may choose to have these blood tests if the dr thinks they could help or something new shows up on us. (Heaven forbid!!)

Why do we all get so freaked out when there really is such a low chance of these cysts being cancer?  I am grateful my dr did an us ASAP a week after I started symptoms of pain, nausea, indigestion and stomach "rumbling".  These symptoms, from what I understand, are consistant with cysts and cancer.  Of course nerves could certainly add to the severity of these symptoms.

I can't let the concern for this cyst dictate my daily life activities and consume my every thought.  I know this will be hard to do, but I am determined to not let my quality of life suffer until someone tells me, definitely, I have cancer.

Good luck to all of you. I'll be sending positive thoughts your way!!!

[MickeyVicki]

According to my doctor, part of the emotional turmoil is most likely due to the effects that ovarian masses (be it a cyst or a tumor) have on  hormonal production in addition to the production of prolactins.  I was also in a state of panic when I developed my noticeable symptoms, and looking back later I realized that I had several panic attacks during what must have been the earliest stages of the development of my endometrioma.  I had not had a panic attack in years, and these were likely due to the cyst.  I suppose the effect could be compared to having constant PMS while having a back ache and a migraine on the side.  I cannot stress how much better I felt after the surgery, even though I had the physical  discomfort from the incisions and removal of the ovary.

My regular gyn performed my surgery, but she is a specialist in "complex" gyn surgery and she is also the doctor used by many of the nurses in our area.  I am quite "picky" about my doctors and if I do not like the manner of one then I try another.  I am blessed that I have insurance that allows me to pick and choose my medical providers.

I asked to have the CA-125 test done, but my doctor said that she did not place any value in it --- unless I was indeed found to have cancer during the surgery.  In that event, she said the CA-125 score would be helpful in determining the success of any treatment that followed my surgery.  She rattled off a long list of conditions that can cause elevated CA-125 levels, that included not only endometriosis but things like simple infections or the timing in the monthly cycle.  She did not even suggest a CEA bloodtest.  As I stated earlier, she was relying on her experiences and she decided from the ultrasound report that I would have exactly what she found.  Of course, that was of no particular comfort to me at the time!!!  I was in a panic.

I used the extra "strength" generated by my panicked state of mind to  prepare myself and my home for my surgery and recovery.  I used the pre-op and post-op checklists on www.hystersisters.com (or something like that!) to keep my mind focused on what I needed to do.  The busier that I was, the better off I seemed to be.

Anyway, you have my prayers for success and recovered health  like mine, whether you need surgery or not.  Do keep us posted on your progress.

[sas/sam]

Thank you for your response.  I am still debating whether or not to have the CA125 and CEA done.  If elevated, I will freak, if normal, it doesn't mean things are ok either.  If I decide to have it done, I will prepare myself mentally for the real possibility of it being elevated due to endometriosis.  My dr says even an elevation of 200 could still mean benign disease.  Is the dr that removed your cyst an obn/onc or your regular ob?  I am getting a second opinion on Oct. 5 and see one of my dr collegues on Sept. 29 for her opinion.  (My dr has a very blunt, aprubt bed side manner which is not what I desire. )

Thanks for the info on benign verses malignent statistics.  I was on fertility drugs 13 years ago for approximately a total of 9 months-not consecutive.  I just have to keep telling myself that things are in my favor!!

What did you do for pain relief?  Ibuprofin doesn't touch the pain when it is really bad.  I haven't asked the dr for anything stronger because of drowziness it can cause.

Glad to hear you are feeling good after your surgery. It sounds like that may be the road I am heading down if this cyst keeps growing.   I would prefer they just take the cyst and what every else needs to come out!! My husband and I are done having our family.  

Look forward to any more insight you may have.

[Patty57]

I have had two CA125s done. One directly after a Drs appointment, which was in the hospital and he called me next day.  Another, I was sent to a blood lab, via a different doctor, in which it had to be sent out and took about 5 looooooooooooong days to come back!!
I am headed for lap surgery this Tues to check out a complex cyst.  Not sure if it is new or the same ole one they have been monitoring over the summer.  My past US was done at the hospital where my gyn/onco dr is and they do not have the films from my previous US done at a different facility.  the most recent report of the US prompted my dr to do a lap to check it out.  

Patty in NC

[MickeyVicki]

I had an endometrioma removed last year.  I had a multitude of symptoms; some so mild that I was not certain they were indeed symptoms until my cyst was found, while others were more severe and led to my appointment with the doctor.  My primary symptoms included a feeling of fullness after eating even a light meal, feelings of gas "rolling around" in my intestines (I am not sure quite how to describe that sensation!), "twinges" in my abdomen (another one that I cannot quite describe), missing a monthly cycle , my abdomen swelled so that I need two sizes larger jeans within  two months, general feelings of tiredness, difficulty bending over or walking up steep hills (these happened at the end, just before my surgery), and night sweats.

Oddly, but common according to my doctor, my symptoms led me to expect a cyst or tumor on my right ovary.  Instead, my left ovary was affected.

I had never been diagnosed with endometriosis prior to my surgery but my doctor discovered during surgery that I have a terrible case of it, and have had it for some time (due to the presence of old adhesions.)

I made the appointment with the doctor, and she did a CA-125 blood test.  Even though it later turned out that I do have endometriosis, my CA-125 level was in the normal range.  

At the time of my ultrasound, my cyst was diagnosed as complex and contained some solid components.  It was  some 6 cm  by 5cm; by the time it was removed a few weeks later, it had grown to nearly 15 cm, and had attached itself to various points in my abdomen.   By the time of the surgery, I was in acute pain from the cyst. The surgery was done laparascopically, and despite all the scary medical descriptions that raised the possibility of cancer, the cyst was found to be benign.

So, I understand exactly what you are feeling right at this moment!

[sas/sam]

Just talked to my dr. The cyst is 4.8x3.5x4.9 showed no blood flow to the cyst, no fluid in my abdomen.  The only concern she has is the cyst is comlex and not simple which means it could be blood filled or be an endometrioma.  She of course would not say that is in NOT cancer.  She said it was up to me whether I want a CA 125 and CEA (because of my gastro symtoms).  I am torn with what to do.  I have a history of endometriosis and this is a condition that could elevate the CA 125.  As far as the CEA, I don't want another ting to worry about.  I am also going for a second opinion with another dr next week.  Does any one know about cyst size and chances of it being cancer?  I am in alot of pain and hope another trip to the ER is not in my furture.  Any advice or comments would be greatly appreciated.  P.S. Has any one had gastro symptoms with a cyst???

[MickeyVicki]

One of the problems with diagnosing these ovarian conditions is that the symptoms are the same for all of them - whether benign or malignant.  I would ask to speak with the doctor directly, at least to ask for the specifics of the diagnosis and why he or she believes that the cyst will resolve on its own.  You can always seek a second opinion too.  I will say this - my doctor is very experienced in gyn surgeries and she made a decision about what she expected to find when she performed my surgery based on the test results, and she was exactly right about my complex cyst.